Thursday, January 29, 2015

Given our politically correct age and given that the
transgendered are now an oppressed class, it took courage for New York Magazine
to look at the question of Body Integrity Identity Disorder (BIID).

And to treat it as a psychiatric condition, falling
somewhere between a mania and a delusion.

A patient with BIID knows exactly what he wants. He wants to
have one of his healthy limbs amputated. Since he is convinced that his left leg is not
really part of his body, he believes that whoever put it there made a mistake.
He believes that he will never be whole until it has been amputated… above the
knee.

New York Magazine explains:

Rather
than a coherent psychological disorder, BIID is better thought of as a cluster
of conditions, united by the strong sense in a sufferer that a limb, usually a
leg, shouldn’t be attached to their body — a sensation of not “fitting” one’s
body akin to gender dysphoria.

Note well that the condition resembles “gender dysphoria,”
the technical term for those who believe that their true gender identity
differs from their biological gender identity. That is, the transgendered.

It is worth noting that gender dysphoria, like BIID, is a
belief. It is not a scientific fact. And, like BIID, it manifests itself in an extra belief-- that the problem can only be solved by surgery.

A BIID sufferer, quoted in the article, describes his belief
as obsessive.

In his words:

My
biggest problem is a complete secret: I have an unexplainable desire to do
something that most people would dread. I want to have my left leg amputated,
just above the knee. I strongly feel that my left leg just shouldn’t be on my
body. I’ve thought about it obsessively every single day of my life.

The patient describes how his mind relates to his offending
limb:

It’s a
strong feeling that I should have been born without my left leg. If I make eye
contact with it and I’m not fully concentrating on something else, I obsessively
think: This leg shouldn’t be there. And it’s very disturbing
because I know that’s not normal. It’s like my brain perceives my body without
a left leg. I can be talking to someone and suddenly unable to focus on what
they are saying because I’m thinking about my leg and wishing it wasn’t
there. It’s an overwhelming urge. I might be dozing on a recliner and I
get this weird feeling around my knee that that’s where it needs to be off. The busier I am the more I
can control it, but if I get stressed the thoughts intensify.

What triggered the disorder? He explains:

When I
was about 5 or 6. I was in downtown L.A., and since it was just after the war,
there were lots of amputees around. I vividly remember seeing a man get off a
streetcar. He had a peg leg and I thought: I wish that were me. Later, I began to tuck my foot
right up behind my bottom when I was in bed at night — little kids are very
flexible. I’d then place the covers down over my knee so it looked like there
was nothing there.

And he had other experiences that added to the childhood
trauma:

When I
was a kid, a relative’s husband got his hand stuck in a machine and he cut some
of his fingers off. I recall visiting them and they were playing cards with
another couple he’d met through rehab. I shouldn’t even remember any of this
except this other guy had lost his left leg. He was sitting in a chair, wearing
a pair of jeans, and his leg was off above where the cuff of the jeans were so
the cuff was empty.

It
stuck in my mind. It was around the same time I saw the guy with a peg leg.
Later a close male relative who was a race-car driver got in a bad accident and
ended up having his leg amputated.

Was the problem caused by a series of incidents that appeared to be connected?
Did their confluence suggest that someone was trying to tell him something?
Perhaps, but I do not know.

For the record, the man's understanding of the etiology of his condition will not change his condition. It will not persuade him to abandon his other
delusional belief, namely that surgery can solve his problem.

For most of his life this man had kept his condition a
secret. When he told his second wife, he felt some relief, but he saw that she was distressed by the information. He chose to stop talking about it.

He has done online research into those who have undergone
the operation. (You are not surprised to learn that some of these people manage to get the operation done. Some manage to hurt themselves so badly that the operation becomes inevitable.) The results were less than encouraging:

But
there are some people I have exchanged emails with, via an online group. All of
them have had left leg amputations. They still obsess about their limbs and
talk about other amputations even though the leg is gone and they claim to be
much happier. My dream is if I had this leg amputated it would all go away and
I’d be a normal person, with a fake leg. That’s the difference between me and
these other sufferers. Having the leg gone but still being plagued by these
thoughts would make my life worse.

Some people insist that surgery has cured them, but large
numbers of those who have had their left legs removed have discovered that they still suffer from their obsessive cravings.

At a time when it is becoming impossible to discuss gender
dysphoria, and at a time when the strength of an individual’s conviction is an
accepted reason for damaging hormone treatment and gender reassignment surgery, it is helpful to see these obsessions or manias in psychiatric terms, the
better not to make them a human rights issue.

Or to make the transgendered pawns in the culture wars.

In a culture where more than a few people believe that there
is no very significant difference between biological males and biological
females and where people also believe that everyone can choose his or her
gender identity, regardless, using individuals who have serious psychiatric
disorders to advance a cultural agenda is frankly cruel.

Culture warriors seem to want to trot out those who suffer
from gender dysphoria as proof that gender is a social construct, or better,
that it can be corrected surgically.

To them, this condition proves definitively that
biology is not destiny. It proves that we can, with the aid surgery, make
ourselves whatever we want to be.

I would add that we do not know whether all the talk about
the transgendered is causing people to convince themselves that they have the condition
when they do not.

After all, gender dysphoria is an obsessive belief. Since
cultural attitudes impact belief, even to the point of producing waves of
certain psychiatric disorders—like hysteria during the Victorian period—it
might well be that the current glorification of the transgendered is persuading
more people that they have the condition.

re: ...we do not know whether all the talk about the transgendered is causing people to convince themselves that they have the condition when they do not.

So the predicament is if "intersex" is biologically real in a tiny fraction of the population, it might be better to not talk about it, since it'll make people unhappy, and it might confuse people.https://en.wikipedia.org/wiki/Intersex

I admit the idea of surgical solitions seems repulsive in the extreme.

I'd perhaps put it in the same category as any cosmetic surgery. And the same problem happens there - you know someone who is unhappy about how they look, and get surgery and it seems successful, you're more likely to consider your own.

What's irrational is any certainty of belief, that you'll feel better about yourself after a surgery than before, I mean assuming it goes entirely as planned.

Ideally there would be a way to test such beliefs before you invest in irreversible surgeries.

It is interesting to think about the fact that our appearances have been in part "sexually selected" over tens and hundreds of thousands of years. And we might be close to being able to genetically modify our children's appearance to be taller or whatever is currently in fashion.

So for me the whole problem comes down to "choice", as long as things seem random and predetermined, we accept whatever we are, but if someone says we can be something else, Pandora's box is opened and self-hatred becomes a legitimate state of mind, if you're too "cowardly" to get mutilated into some different ideal than you are.

It reminds me of Dr. Seuss's Sneetches, a sucker is born every minute, and all you need is peer pressure and irrational beliefs.https://www.youtube.com/watch?v=PdLPe7XjdKc